NHL

Question 1

Cancers of mature B, T, and natural killer (NK) cells

Answer 1

NON Hodgkin’s Lymphoma

~10× more common than Hodgkin lymphoma

MALE

Question 2

EBV associated malignancy

Answer 2

Burkitt’s lymphoma
Post–organ transplant lymphoma
Primary CNS diffuse large B-cell lymphoma
Hodgkin’s lymphoma
Extranodal NK/T-cell lymphoma, nasal type

Question 3

HTLV-1 associated malignancy

Answer 3

Adult T-cell leukemia/lymphoma

Question 4

HIV associated malignancy

Answer 4

Diffuse large B-cell lymphoma
Burkitt’s lymphoma

Question 5

Hepatitis C associated malignancy

Answer 5

Lymphoplasmacytic lymphoma

Question 6

H pylori associated malignancy

Answer 6

Gastric MALT lymphoma

Question 7

Human herpesvirus 8 associated malignancy

Answer 7

Primary effusion lymphoma
Multicentric Castleman’s disease

Question 8

t(8;14)

Answer 8

Burkitt = Burk8tt

Question 9

t(14;18)

Answer 9

Follicular - Fo14cular

Question 10

t(11;14)

Answer 10

Mantle cell = mantle ce11

Question 11

INDEPENDENT prognostic factor in NHL

Answer 11

β2-microglobulin

Question 12

Tumor burden, prognosis

Answer 12

LDH

Question 13

Imaging use for Indolent lymphomas (staging)

Answer 13

CT chest/abdomen/pelvis

Question 14

Imaging use for aggressive NHL (DLBCL, BL, T-cell)

Answer 14

FDG-PET

Question 15

Detects nodal & extranodal disease

SUV correlates with aggressiveness

Useful for:
o Suspected transformation
o End-of-therapy assessment

Answer 15

FDG-PET

Question 16

Ann Arbor Staging for Lymphoma

Stage 1

Answer 16

Involvement of a single lymph node region (I) or single extranodal site (IE)

Question 17

Ann Arbor Staging for Lymphoma

Stage 2

Answer 17

Involvement of two or more lymph node regions or lymphatic
structures on the SAME SIDE of the diaphragm alone (II) or with
involvement of limited, contiguous, extralymphatic organ or
tissue (IIE)

Question 18

Ann Arbor Staging for Lymphoma

Stage 3

Answer 18

Involvement of lymph node regions on BOTH SIDES OF THE DIAPHRAGM (III) which may include the spleen (IIIS), or limited, contiguous, extralymphatic organ or tissue (IIIE), or both (IIIES)

Question 19

Ann Arbor Staging for Lymphoma

Stage 4

Answer 19

Diffuse or disseminated foci of involvement of one or more
extralymphatic organs or tissues, with or without associated lymphatic involvement

Question 20

International Prognostic Index for NHL

Five Clinical Risk Factors

Answer 20

Age ≥60 years

ELEVATED LDH

Performance status ≥2 (ECOG) or ≤70 (Karnofsky)

Ann Arbor stage III or IV

>1 site of extranodal involvement

Question 21

RARE - <1% of adult NHL (US)
~30% of childhood NHL
MALE usually <35 years old

Extremely aggressive: doubling time <24 hours

MYC translocation (>95%)

Answer 21

Burkitt’s Lymphoma
monotonous medium-sized b cells
proliferation index ~100%
Starry sky” appearance (tingible body macrophages)

Question 22

Intensive combination chemotherapy for Burkitts Lymphoma

Answer 22

**High-dose cyclophosphamide–based regimens¥¥

Dose-adjusted EPOCH-R highly effective

Question 23

MC NHL subtype (~30–35%)

median age at diagnosis: 64 years

slight male and Caucasian predominance

Answer 23

Diffuse Large B Cell Lymphoma

majority present with advanced-stage disease (III–IV)

only 30–40% present with stage I–II disease

B symptoms present in ~40%

Question 24

Diffuse Large B Cell Lymphoma markers

Answer 24

CD19
CD20
CD79a

Question 25

**COMMON ABNORMALITIES in Diffuse Large B Cell Lymphoma markers**

Answer 25

**BCL2 overexpression (25–80%)** **BCL6 abnormalities (>65%)** **MYC rearrangement (~10%)**

Question 26

**Treatment for Diffuse Large B Cell Lymphoma markers**

Answer 26

Standard first-line therapy: **R-CHOP** Early-stage disease: **Full-course R-CHOP or Short-course R-CHOP + involved-field radiotherapy** Advanced-stage disease: **Full-course R-CHOP**

Question 27

**2nd MC NHL** **Indolent (low-grade) lymphoma*¥

Answer 27

**Follicular Lymphoma** **mixture of small cleaved cells (centrocytes) and large cells (centroblasts)** **follicular growth pattern**

Question 28

**MC presentation of follicular lymphoma**

Answer 28

**PAINLESS LYMPHADENOPATHY** **typically multifocal nodal disease**

Question 29

**INDICATIONS FOR TREATMENT FOR FOLLICULAR LYMPHOMA**

Answer 29

**symptomatic disease** **organ dysfunction** **cytopenias** **bulky or high-volume disease autoimmune or inflammatory complications driven by FL**

Question 30

**2nd MC indolent B-cell NHL**

Answer 30

**Marginal Zone Lymphoma**